| NPI | 1124106489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE GARDNER Billing Manager 989-249-8853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-04-13 |